Psychiatry

This chapter in the Oxford Handbook of Emergency Medicine investigates psychiatry in the emergency department (ED). It provides a glossary of psychiatric terms and reviews the psychiatric interview and mental state examination. It explores dealing with the aggressive patient and safe consultations with potentially violent patients, managing aggression, and emergency tranquillization. It discusses self-harm, assessment of suicide risk, mental health assessment issues, depression, mania, schizophrenia, and complications of psychiatric drugs, as well as Munchausen’s syndrome and medically unexplained symptoms. It investigates how to deal with alcohol abuse, acute alcohol intoxication, alcohol withdrawal, alcohol-related brain injury, and help for alcoholics, as well as drug and substance abuse, compulsory hospitalization, and the Mental Capacity Act.

Wounds, fractures, and orthopaedics

This chapter in the Oxford Handbook of Emergency Medicine investigates wounds, fractures, and orthopaedics in the emergency department (ED). It reviews classification and assessment of skin wounds, puncture wounds, and foreign bodies, and discusses wound cleaning, closure, aftercare, infected wounds, bites and stings, tetanus, and needlestick injury. It explores fractures, including open (compound) fracture and dislocation (and subluxation), casts and their problems, and osteoporosis, as well as soft tissue injury, physiotherapy in the ED, and fracture clinic and alternatives. It describes different areas of fracture and injury in detail, including hand, thumb, scaphoid, and carpal injury, Colles’ fracture, Smith’s fracture, Barton’s and reverse Barton’s fracture, wrist injury, forearm fracture, elbow injury, humeral fracture, shoulder dislocation, clavicle injury, neck injury, facial wounds, pelvic fracture, hip dislocation, sacral and coccygeal fracture, femur fracture, knee injury, tibial and fibular shaft fracture, pretibial laceration, calf and Achilles tendon injury, ankle injury, foot fracture and dislocation, toe injury, low back pain, arthritis, and eponymous fractures.

Analgesia and anaesthesia

This chapter in the Oxford Handbook of Emergency Medicine investigates analgesia and anaesthesia in the emergency department (ED). It looks at options for relieving pain, such as the analgesics aspirin, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), morphine and other opioids, Entonox®, and ketamine, and explores analgesia for trauma and other specific situations. It discusses local anaesthesia (LA) and local anaesthetic toxicity, including use of adrenaline (epinephrine) and general principles of local anaesthesia. It explores blocks such as Bier’s block, local anaesthetic nerve blocks, intercostal nerve block, digital nerve block, median and ulnar nerve blocks, radial nerve block at the wrist, dental anaesthesia, nerve blocks of the forehead and ear, fascia iliaca compartment block, femoral nerve block, and nerve blocks at the ankle. It examines sedation, including drugs for intravenous sedation and sedation in children, and discusses general anaesthesia in the emergency department, emergency anaesthesia and rapid sequence induction, difficult intubation, and general anaesthetic drugs.

Major trauma

This chapter in the Oxford Handbook of Emergency Medicine investigates major trauma in the emergency department (ED). It reviews general treatment principles, resuscitation, and investigations, and explores airway obstruction, tension pneumothorax, rib fractures, sternal fracture, flail segment, ruptured diaphragm, oesophageal rupture, traumatic pneumothorax, haemothorax, chest drain insertion, pulmonary contusions and aspiration, penetrating chest injury, open chest injury, traumatic cardiac arrest, thoracotomy for cardiac arrest, aortic injury, focused assessment with sonography for trauma (FAST) scan, blunt abdominal trauma, penetrating abdominal trauma, renal trauma, bladder injury, urethral trauma, scrotal and testicular trauma, minor and serious head injury, post-concussion symptoms, carotid/vertebral artery dissection, maxillofacial injuries, mandibular injuries, temporomandibular joint dislocation, penetrating neck trauma, silver trauma, spine and spinal cord injury, dermatomes, gunshot injuries, blast injuries, burns, inhalation injury, and crush syndrome.

Toxicology

This chapter in the Oxford Handbook of Emergency Medicine encompasses toxicology in the emergency department (ED). It examines poisons in general, including diagnosis, supportive care, reducing absorption, and antidotes. Specific poisoning is explored in detail, through opioid, salicylate, paracetamol, tricyclic antidepressant, benzodiazepine, clomethiazole, phenothiazine, barbiturate, lithium, sulfonylurea, beta-blocker, calcium channel antagonist, digoxin, angiotensin-converting enzyme (ACE) inhibitor, theophylline, salbutamol, iron, ethanol, methanol, ethylene glycol, paraquat, petrol, paraffin, organophosphate, cyanide, carbon monoxide, chlorine, and CS gas (tear gas) poisoning. Chemical incidents are discussed, as well as accidental poisoning from plants, berries, mushrooms, and button batteries. It also examines novel psychoactive substances (NPS), recreational drugs, serotonin syndrome, and body packers.

Life-threatening emergencies

This chapter in the Oxford Handbook of Emergency Medicine examines all aspects of life-threatening emergencies encountered in the emergency department (ED). It examines anaphylaxis and its treatment, as well as choking. It discusses cardiac arrest and its management, as well as in-hospital resuscitation and adult Basic and Advanced Life Support algorithm use, post-resuscitation care, and central venous access. It explores recognition of the sick patient, sepsis, and shock.

Obstetrics and gynaecology

This chapter in the Oxford Handbook of Emergency Medicine investigates obstetrics and gynaecology in the emergency department (ED). It reviews gynaecological problems, vaginal discharge, contraceptive problems, genital injury, assault and female genital mutilation, gynaecological pain, and vaginal bleeding. It discusses the pregnant patient and explores prescribing, hyperemesis gravidarum, vaginal bleeding, miscarriage, ectopic pregnancy, vaginal bleeding in later pregnancy, abdominal pain, and medical complications of pregnancy. It also reviews emergency normal delivery, obstetric emergencies, trauma and cardiac arrest in pregnancy, and post-partum problems.

Ophthalmology

This chapter in the Oxford Handbook of Emergency Medicine investigates ophthalmology in the emergency department (ED). It examines a general approach to eye problems before dealing with specific issues such as corneal trauma, contact lens problems, blunt eye injury, penetrating eye injury, sudden visual loss, the red eye, and pupillary abnormality.

Environmental emergencies

This chapter in the Oxford Handbook of Emergency Medicine investigates environmental emergencies in the emergency department (ED). It starts by examining the presentation and management of hypothermia, frostbite, and non-freezing cold injury. It examines drowning, near drowning, and diving emergencies, and also explores heat illness, electrical injury, and radiation accident.

Infectious diseases

This chapter in the Oxford Handbook of Emergency Medicine discusses infectious diseases in the emergency department (ED). It starts by examining the general subjects of incubation periods, notifiable infectious diseases, and childhood diseases. It goes on to explore specific diseases, including meningitis, acute encephalitis, herpes simplex virus, herpes varicella-zoster, Zika virus, gastroenteritis/food poisoning, fish poisoning, infestations, tuberculosis, anthrax, streptococcal infections, staphylococcal infections, tetanus, gas gangrene, botulism, sexually transmitted infections, hepatitis, leptospirosis (Weil’s disease), and human immunodeficiency virus (HIV). It discusses imported infectious diseases, such as malaria, typhoid and paratyphoid (enteric fever), dengue, poliomyelitis, rabies, viral haemorrhagic fevers, and severe acute respiratory syndrome, before looking at influenza pandemics, avian flu, and swine flu.